RIDGEWOOD EMERGENCY GROUP, LLC (NPI# 1750862694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750862694 |
| Entity Type | Organization |
| Organization Name | RIDGEWOOD EMERGENCY GROUP, LLC |
| Practice Address |
40100 Highway 27 Davenport FL 33837-5906 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 8634224971 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2018-08-28 |
| Authorized Official Name | LISHA C FALK (VP OF CONTRACTING) |
| Authorized Official Telephone | 8008939698 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
40100 HIGHWAY 27 |
| City | DAVENPORT |
| State | FL |
| Zip Code | 33837-5906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396726451 | Mark D Tran | Anesthesiology | 40100 Highway 27, Davenport, FL 33837-5906 | 2005-11-07 |
| 1801457510 | Adventhealth Polk North Inc | General Acute Care Hospital | 40100 Highway 27, Davenport, FL 33837-5906 | 2019-06-24 |
| 1720552045 | Maria Divina Lim Sia | Nurse Practitioner | 40100 Highway 27, Davenport, FL 33837-5906 | 2019-01-20 |
| 1295216034 | Ridgewood Physician Services, LLC | Physician Assistant | 40100 Highway 27, Davenport, FL 33837-5906 | 2018-08-28 |
| 1952803751 | Alex Clough | Dietitian, Registered | 40100 Highway 27, Davenport, FL 33837-5906 | 2018-03-07 |
| 1548778418 | Multispecialty Health Network of Florida, LLC | Orthopaedic Surgery | 40100 Highway 27, Davenport, FL 33837-5906 | 2018-01-13 |
| 1972039592 | Nixon Simon | Nurse Practitioner | 40100 Highway 27, Davenport, FL 33837-5906 | 2017-05-02 |
| 1487105292 | Ivonne Hazim | Registered Nurse | 40100 Highway 27, Davenport, FL 33837-5906 | 2016-10-17 |
| 1285084533 | Eyad Rawhi El Far | Family Medicine | 40100 Highway 27, Davenport, FL 33837-5906 | 2016-06-17 |
| 1922465525 | Rachel Alison Kenyon | Nurse Anesthetist, Certified Registered | 40100 Highway 27, Davenport, FL 33837-5906 | 2016-01-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922612274 | Kimberly Zariya Honaker | Massage Therapist | 398 Madison Drive, Davenport, FL 33837 | 2020-09-03 |
| 1609480375 | Sun Health and Wellness, Inc | Pharmacy | 109 Park Place Blvd, Suite A, Davenport, FL 33837 | 2020-09-01 |
| 1093323156 | Tammey Davis Payne | Counselor | 1423 Merrimack Lane, Davenport, FL 33837 | 2020-07-15 |
| 1346872835 | Shelly Hanson | Dietitian, Registered | 40100 Us 27, Davenport, FL 33837 | 2020-02-12 |
| 1689221269 | Adventist Health System /sunbelt, Inc. | Clinic/Center | 40124 Us Hwy 27, Suite 205, Davenport, FL 33837 | 2019-08-20 |
| 1578029039 | Portia P White | In Home Supportive Care | 108 East James St, Davenport, FL 33837 | 2019-02-20 |
| 1366937146 | Sheetal Kirat Parikh | Dietitian, Registered | 40100 Us Highway 27, Davenport, FL 33837 | 2018-06-25 |
| 1063929883 | Marisa Christine Sweetser | Registered Nurse | 40100 Us-27, Davenport, FL 33837 | 2018-01-02 |
| 1104341460 | Haley Kampf | Behavioral Analyst | 4303 Cortland Dr, Davenport, FL 33837 | 2017-08-08 |
| 1013438373 | Tamara Michelle Ortiz | Speech-Language Pathologist | 206 Nova Drive, Davenport, FL 33837 | 2017-06-27 |
| Find all providers in zip 33837 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285997692 | Anthony John Appel | Emergency Medicine | 34100 Teel Hill Rd N, Davenport, WA 99122-9596 | 2012-06-20 |
| 1477638005 | Charles Reed Holt | Emergency Medicine | 2026 N Main St, Davenport, IA 52803-2911 | 2006-10-25 |
| 1730140435 | Steven Blake Bashor | Emergency Medicine | 1227 Rusholme Ave, Genesis East Hospital, Davenport, IA 52803 | 2006-03-31 |
| 1841268794 | John Wescott Conboy | Emergency Medicine | 40100 Hwy 27, Davenport, FL 33837 | 2006-03-08 |
| 1316948987 | Douglas Hamilton Gaither | Emergency Medicine | 5820 Belle Ave, Davenport, IA 52807-2782 | 2005-08-09 |
| 1710364492 | Brittany B Price | Emergency Medicine | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2015-05-01 |
| 1750798872 | Elisa Smith | Emergency Medicine | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2014-07-21 |
| 1831503820 | Michael David Craddick | Emergency Medicine | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2014-06-17 |
| 1821401506 | Morgan Cole Barnell | Emergency Medicine | 1227 E Rusholme St, Davenport, IA 52803 | 2014-06-10 |
| 1366889909 | Kelly Marie Douglas | Emergency Medicine | 1227 E Rusholme St, Davenport, IA 52803-2459 | 2013-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.